By Sue Montgomery, The Montreal Gazette
It’s normal, an aid worker told her, not to menstruate after suffering severe trauma such as an earthquake.
But when her period still hadn’t shown up five months after January’s massive tremor that claimed the lives of her husband and hundreds of thousand others in Port-au-Prince, the desperate woman spent a precious $2 on a pill to abort the fetus she knew she could never support. After a night of writhing in pain under her tarp and next to her three children, the pale and weak woman sought help at a local makeshift clinic.
“I listened with the Doppler, and for the first time in my career, I said, ‘Sorry, Madame, but your baby is still alive’,” recalls my sister Ann Montgomery, a Toronto midwife who spent time recently in one of Haiti’s camps. “She just lay there on the cot with her hands over her eyes … then gradually she got up, arranged herself, thanked me with a tired smile and left.”
Natural disasters in poor countries can be so devastating, survivors sometimes wonder whether they’d have been better off dying when the earth shook or the flood waters came rushing in. Such catastrophes are unforgiving and indiscriminate with their victims, but studies have shown that a higher proportion of women die during the disaster.
In 2005, Oxfam reported that up to four times as many women as men died in the 2004 tsunami, and in many cases, it was the yards of material in their saris that anchored the women under the water.
As for the females who make it through alive, their vulnerability is only exacerbated, and survival can indeed often feel like death.
A study conducted post-earthquake by the Institute for Justice and Democracy in Haiti found that of the 69 victims they interviewed, many of whom had been raped, 95.7 per cent were suffering from post-traumatic stress syndrome and 53.6 per cent were suffering from depression.
“Several women indicated suicidal tendencies and some had even taken steps toward ending their lives,” said the report, which was published in July. “At least one woman said she had contemplated killing herself and her children.”
One woman, who had lost her husband and home in the quake, said she wanted to end her life because “this life had gone bad.”
Such events obviously affect men, as well. A 2005 World Health Organization report on Gender and Health in Natural Disasters noted that men, as traditional family providers and protectors, often feel like failures if they were unable to save their loved ones. To compensate, some may take greater risks as volunteers and rescue workers in the relief effort. But they also tend to abandon women and children soon after the disaster, grabbing food aid and materials for themselves.
The 2004 tsunami in the Indian Ocean, Hurricane Katrina in New Orleans in 2005, this year’s earthquake in Haiti and now the floods in Pakistan, to name just a few recent natural disasters, not only killed hundreds of thousands of women, often because they’d never been taught to swim or climb a tree, they left countless female survivors to fend for themselves and their children, making them targets for sexual assault or forcing them to barter sex for food or shelter.
The head of UNICEF in flood-ravaged Pakistan said women and children make up 70 per cent of the nearly 18 million people affected by the disaster. (Women in developed countries aren’t immune either. When New Orleans flooded, 41 per cent of all female-headed households were already living in poverty, laying the groundwork for a bleak future).
In countries where women aren’t allowed to own property, such as Pakistan, many were left homeless when their husbands perished. Premature births, miscarriages and urinary tract infections, are also the plight of women in makeshift, unsanitary camps that sprout up after disaster strikes.
Increasingly, relief organizations are realizing that any aid brought into a ravaged region has to take into consideration women’s needs for everything from sanitary pads to protection from rapists -but not one blueprint for help applies to all. Failing to consider cultural differences in the equation can mean the difference between help and a complete waste of effort, time and money.
For example, the Montreal-based Centre for International Studies and Co-operation (CECI) focuses solely on women during any emergency response.
“Because of the traditional role women play in food security, if you help the woman, you help her children,” said Odette McCarthy, program and gender specialist with the organization. “But if you help the man, that won’t happen.”
She said that CECI responded to the earthquake in Haiti knowing that 47 per cent of households are headed by women -a large chunk of the population that is going to be more vulnerable after a disaster.
“That has to be part of your strategy when delivering aid,” said Mc-Carthy. “If it isn’t, you’re going to put them at more risk for sexual exploitation.”
CECI responded not only by consulting local women’s groups to learn what items would be useful in survival kits, they ensured the kits wouldn’t be so heavy that women couldn’t carry them. They also set priorities when distributing a mere 150 tents in a camp of about 5,000 families, explaining to other, less vulnerable survivors why a pregnant woman should get shelter before anyone else.
“We took that vulnerability into consideration in every intervention we made,” said McCarthy, who has worked in Haiti for three years.
CECI also looked beyond the immediate problems by funding women who lost their small kiosks or businesses in the quake to get back to work.
“The prospect of them restarting was almost nil,” McCarthy said. “And they could have fallen into prostitution as a result.”
The initiative was so successful that CECI is now helping about 5,000 women in the outlying regions, where an influx from flattened Port-au-Prince has put enormous pressure on the area.
Often, aid organizations fail to
work closely with the plethora of dynamic, local women’s groups, shutting them out of the post-disaster planning, which results in missed opportunities to help effectively.
“Right now, they aren’t playing key roles in the decision-making of aid coming in during those first few months,” McCarthy said.
A 2005 Global Fund for Women report, titled Caught in the Storm, noted that in Sri Lanka after the tsunami, temporary houses were built without any kitchens or provisions for cooking because women hadn’t been included in the short-term relief planning. The same has been reported in Haiti, where international NGOs hold their meetings at the UN logistics base, far from and inaccessible to women living in camps.
Julie Mc Hugh, humanitarian program officer for Oxfam Quebec, said that while intervening in one natural disaster, an aid organization distributed sanitary pads to women, only to learn through the puzzled looks on their faces that the women didn’t wear underwear.
To try to avoid such cultural faux pas, Oxfam recently created a Gender in Emergencies working group to compare notes and learn from mistakes made during disasters.
“We always have to adapt, because it’s not the same recipe everywhere,” said Mc Hugh, who is a member of the group. “Our motto is always ‘do no harm,’ but if we don’t react properly, we could harm women more.”
Other well-meaning organizations have distributed formula to help malnourished nursing mothers feed their children, she said. But the young ones often ended up with diarrhea and vomiting when the powder was mixed with dirty water.
In armed conflict, it is the male death toll that is usually the highest. But cultural norms, maternal instincts and simple biology all work to put women in a more precarious situation during a natural disaster. Either they stay behind to help rescue their children (many Haitian woman -either mothers or nannies -were crushed as they ran to other rooms in their homes to grab their children), are physically unable to scramble up trees or walls, have never learned to swim, or simply wait for instructions from their male partner before making a run for it.
According to WHO, a study on a 1991 cyclone in Bangladesh noted that many women perished with their children at home as they waited for their husbands to return and make an evacuation decision.
As it was in Haiti and in other post-disaster situations, reproductive health is a concern in Pakistan, especially since an estimated half a million women are expected to give birth during the next six months. Save the Children warned that women are already giving birth in flimsy shelters, next to dirty water. Complicating matters is the lack of female health-care providers, especially gynecologists, in the affected areas.
In almost every natural disaster,
says Mc Hugh, women’s increased vulnerability and the collapse of law and order in society result in a significant increase in sexual assault. Women, desperate to feed their children, are often forced into sex acts in exchange for food, medicine or shelter. Children orphaned by a natural disaster are also at risk of sexual exploitation.
Such violence isn’t unique to developing countries. Sexual assault rose by 300 per cent following the Loma Prieta earthquake in California in 1989. In many cases, the victims were women who were forced to return to an abusive relationship after losing their shelter. The International Violence Against Women Act, a bill now before the House Foreign Affairs Committee, provides for the State Department to help expand the capacity of international humanitarian organizations in disaster situations to protect women and girls.
Meghan Rhoad, a women’s rights researcher with Human Rights Watch, said the bill is long overdue since the phenomenon of violence against women has been a known issue for some time.
“We know what it takes to be prepared,” she wrote in the Miami Herald. “Now, it is time to do what it takes to halt the violence.”
In Haiti, the United Nations has assigned a unit of 130 Bangladeshi female soldiers to protect and accompany Haitian women, although grassroots women’s groups say what is needed is security in the camps in the form of a serious police force and a justice system that will prosecute rapists.
As in most disasters, the quake in Haiti destroyed women’s support systems and their livelihoods, forcing them to live in crowded, unlit camps, where the sense of cooperation and sharing that was so noticeable immediately after the quake has long been replaced with a survival-of-the-fittest attitude. In addition to looking after their own children, women have also stepped in to care for dozens of children whose parents either died in the earthquake, or are living in another camp, unaware their offspring are still alive.
“Overcrowding, lack of privacy, weakened family and community structures, among other things, render women and girls particularly vulnerable to sexual violence,” the Institute for Justice and Democracy in Haiti report says.
“Women and girls live in inadequate shelter, often sleeping under nothing more than a tarp or blanket, with no means of protection and no friends close by, and bathe in public in view of men and boys.”
For Pakistani women who are
Muslim, such living conditions are intolerable. Most have never lived with other men, other than family members. And receiving aid or medical help from men is also taboo. The complete lack of privacy can lead to health problems, as noted in the 2005 WHO report.
During the 1998 floods in Bangladesh, it said, adolescent girls reported not being able to wash out menstrual rags properly in private, often had no place to hang them to dry, or access to clean water. As a result, they suffered from perineal rashes and urinary tract infections.
McHughsaidpartof thesolution is hiring local women who understand the culture to provide aid in times of disasters.
But it’s also a question of attacking the root problems of women’s vulnerability before a disaster strikes, McCarthy said, and not being in denial of that vulnerability when a country is in tatters.
“There has to be prevention,” she said. “Every development project that gets approved has to take into consideration the difference between men and boys, women and girls.
“And in 2010, there are still projects that don’t.”
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